This GP thing

I want to mention a few compliments I've had recently. I'm a bit reluctant to keep listing these because it looks as though I am blowing my own trumpet. In fact I know that I am not an excellent GP. I do not “strive for excellence” because I hate that weasel phrase, I just try to be “good enough”. I am a bog standard GP. But GPs are getting a bad press at present which appears to be engineered by Her Majesty's Government. I mention these compliments because they show what some of Her Majesty's subjects think of one of Her bog standard GPs.

Two patients have spontaneously expressed the hope that I am not going to retire soon. One is a delightfully twittery and slightly anxious elderly lady who has much to be anxious about. “Don't retire, will you. It gives me confidence that you're there” said she. The other is a younger woman who has suffered from quite severe mental health problems for more than a decade. “You're not thinking of retiring are you? I don't know what I'd do without you here.” I found this a little odd at first, because nowadays I only see her about once a year and her mental health problems are mostly sorted out by the secondary care services. Yet I saw her a lot in the early days when her illness was developing and we formed some sort of bond which still persists.

I don't know why they should both suddenly fear that I am going to retire soon. (In fact that is my intention, for personal reasons as well as being completely hacked off by Her Majesty's Government and the burgeoning and choking hand of regulation. But only a few people know about it.) Perhaps I look older than my years - losing my hair certainly hasn't helped, and I observe with a tinge of sadness that most of my good looking young female patients evidently see me more as a kindly elderly relative than a possible sexual predator. Or perhaps news that GPs are generally demoralised is spreading?

Then today I was given a compliment that really pleased me, by a junior hospital doctor. A few weeks ago he came to see me for the first time with symptoms suggestive of inflammatory bowel disease. It was the first time he had seen a GP for years and he was a bit embarrassed, particularly as he had been ignoring the symptoms for some time. I think that doctors deserve good treatment from their colleagues, so I was at pains to reassure him that he had nothing to be embarrassed about. I arranged the appropriate blood tests and referral, and gave him some treatment immediately because it's hard being a junior hospital doctor when you are constantly having to run to the toilet. And I gave him some treatment for a skin condition which he had also been ignoring. When I saw him again today I learned that the hospital investigation had confirmed the diagnosis, that his symptoms had cleared up almost immediately after starting my treatment, and that he was feeling better than he had for a long time. I asked how his skin condition was doing, and a smile appeared on his face. “Hey, this GP thing really works” he said, “that's better too!”

Yes ladies and gentlemen, this GP thing really works, though the Government doesn't think so. A GP (rather than a Health Care Professional with a Protocol) can assess, diagnose, treat and refer in an efficient manner tailored to the needs of the patient. And a GP can provide a supportive long-term personal service which is highly valued by vulnerable patients. We do lots of other good things as well: efficient prescribing and use of NHS resources, health promotion and screening, absorbing and coping with a vast amount of uncertainty, and filling in the gaps between the different contract-driven NHS services. And other things I'm not clever enough to think of just now. So why does the Government run smear campaigns against us, force us to work extra hours when we are exhausted while cutting our profits yet again, evidently intend our profits to continue to fall for years to come, and want to replace us by cheap inexperienced sessional doctors and Health Care Professionals in polyclinics? It may be that Joni Mitchell was correct: “don't it always seem to go that you don't know what you've got 'til it's gone”.

The NHS has got me for another two years, then I'm off in my big yellow taxi.